tbuckley/cabot-search huggingface dataset:
AB0179 PATIENT’S SATISFACTION WITH TREATMENT IN RHEUMATOID ARTHRITIS: AN UNMET NEED
Authors: W. Belhaj, S. Miladi, A. Fazaa, H. Boussaa, L. Souebni, K. Ouenniche, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2022)

Background Shared decision between rheumatologists and their patients has become an overarching principle in current treatment recommendations in rheumatoid arthritis (RA). Therefore, assessing satisfaction with pharmacological therapy, among patients, is becoming increasingly important in clinical settings. Objectives In this study, we aimed to assess the satisfaction of patients with RA about their treatment and to investigate the predictive factors. Methods A cross-sectional study was conducted including adults diagnosed with RA for more than a year and receiving their current Disease-modifying anti-rheumatic Drug(s) (DMARD(s)) for at least 12 months. We used the treatment satisfaction questionnaire for medication (TSQM v1.4) to assess the treatment satisfaction among patients. Multivariable regression analysis was applied to determine the factors associated with treatment satisfaction. Results We included 70 patients (63F/7M) with a mean age of 57.8 ±10.6 [29-81] years at the time of the study. The mean disease duration was 13.71±7.2 [2-30] years. Twenty-four (34,2%) patients were on a biologic DMARD (bDMARD). Regarding the Disease Activity Score 28 (DAS28-ESR), 14.3% of patients had a low disease activity, 47.1% a moderate disease activity, 7.1% a high disease activity, and 31.4% were in clinical remission. The mean (SD) Rheumatoid Arthritis Impact Disease (RAID) overall score was 4.72 ±2.11. Mean (SD) TSQM scores were 65.42±14.77 for convenience, 68.71±18 for effectiveness, 70.60±24.5 for side effects, and 67.95±17.10 for global satisfaction. Twenty percent of patients were satisfied with convenience, 38.6% were satisfied with effectiveness, 45.7% were satisfied with side effects and 30% were globally satisfied. The multivariable regression analysis showed that the RAID overall score was inversely associated to global satisfaction (p=0.001) and to satisfaction with effectiveness (p=0.032). Difficulty of coping (one of the RAID domains) was inversely associated to satisfaction with effectiveness and convenience. It was, also, showed that satisfaction with side effects was inversely associated to the degree of interference of the RA on domestic work (p=0.020) and positively correlated to the degree of participation in treatment decision-making (p=0.014). In addition, satisfaction with current physician was positively associated to global satisfaction (p=0.029). Satisfaction with convenience was inversely associated to bDAMARs (p=0.027). Conclusion We conclude from our data that despite the diversity of therapeutic strategies, almost two-thirds of patients remain not satisfied with their treatment. A better understanding of patients’ unmet needs and an individualized patient-centric approach would improve outcomes in RA. Disclosure of Interests None declared
AB0778 Baseline CRP Level and Response to Infliximab Treatment in Spondyloarthritis
Authors: S. Sayouri, N. Akasbi, H. Bourkhime, I. El Mezouar, T. Harzy
Journal: Annals of the Rheumatic Diseases (2022)

Background The treatment of spondyloarthritis (SpA) is based on cDMARDS (Conventional disease-modifying anti-rheumatic drugs) and bDMARDS (Biologic disease-modifying anti-rheumatic drugs) and aims at remission or low disease activity. Elevated C-reactive protein (CRP) is a good marker of inflammation [1]. Objectives Our goal was to find a link between the CRP level and the response to infliximab. Methods Retrospective study was conducted in the rheumatology department at the University Hospital of Fez from January 2011 to January 2021. The patients were recruited according to the ASAS 2009 criteria (Assessment of Spondyloarthritis International Society). A negative CRP is defined as less than or equal to 6mg / L and the ESR (Erythrocyte Sedimentation Rate) according to age. The main criteria for evaluating the response to the biological at 3, 6 and 12 months are: BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and ASDASCRP (Ankylosing Spondylitis Disease Activity Score). The secondary criteria are: global evaluation (EVA) and ESR. They were divided into 2 groups according to the CRP while seeking its link with the response to infliximab and with the other epidemiological, clinical and biological parameters. Results 375 SpA patients including 65 on infliximab: 50.8% men and 49.2% women. Mean age was 43.40(±1.86) years. Average duration of evolution was 7.71(±6.33) years. Mean baseline CRP was 35.1(±42.7) mg/L. Mean baseline ASDASCRP was 4.04(±1.49). 77.4% had a good ASDAS CRP response to treatment and 22.6% had no response. 59.7% had a good answer according to BASDAI. The bivariate analysis did not find a significant relationship between the initial CRP and the main treatment response criteria: ASDASCRP (p=1) BASDAI (p=0.14), nor with ESR (p= 0.09) and overall EVA (p=0.1). Conclusion No relationship was found between baseline CRP and disease remission. Further studies with a larger sample would be needed to discuss these results. References [1]A. Guich et al, Taux de CRP initial et réponse au traitement biologique de la spondylarthrite, Revue du rhumatisme 87 (2020) A107–A293 Disclosure of Interests None declared
AB1116 RESULTS OF PRESCRIBING BIOLOGIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS AND JANUS KINASE INHIBITORS FOR RHEUMATOID ARTHRITIS DURING THE COVID-19 PANDEMIC: DATA FROM A TELEPHONE SURVEY OF 254 PATIENTS.
Authors: A. Potapova, A. Karateev, E. Pogozheva, E. Matianova, A. Bobkova, A. Semashko, E. Filatova, V. Amirdzhanova, E. Zotkin, A. Lila
Journal: Annals of the Rheumatic Diseases (2022)

Background Prescribing biologic disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase (JAK) inhibitors during the global pandemic of coronavirus disease 2019 (COVID-19) requires a balanced approach and rigorous monitoring of patients’ condition. Objectives To evaluate the effect of bDMARDs and JAK inhibitors on the condition of patients with rheumatoid arthritis (RA), taking into account the outcomes assessed by the patients themselves, as well as the incidence of COVID-19 in these patients. Methods A telephone survey was conducted of 254 patients with RA (age 49.8 ± 13.7 years, 83.5% women, RF + 64.4%, DAS28 5.4 ± 1.6), who in the period from January 2020 to June 2021 by decision of the medical commission of the V.A. Nasonova Research institute was first prescribed bDMARDs or JAK inhibitors: rituximab (RTX) - 148 (58.3%), TNF-a inhibitors - 57 (22.4%), JAK inhibitors - 20 (7.9%), IL 6 inhibitors - 17 (6 .7%), abatacept - 12 (4.7%). Results At the time of the survey, 204 (80.3%) patients continued to take the prescribed drugs. The main cause discontinuation of treatment was for non-medical reasons. Synthetic DMARDs (mainly methotrexate and leflunomide) were received by 68.0%, glucocorticoids - 45.3%, non-steroidal anti-inflammatory drugs - 44.5% of respondents. Among the patients who took bDMARDs or JAK inhibitors, 68.1% noted the “state of symptoms acceptable to the patient”, the absence of frequent joint pain - 65.3%, increased fatigue - 14.3%. The incidence of COVID-19 and hospitalization associated with this disease didn’t differ between individuals who continued and discontinued the use of bDMARDs or JAK inhibitors: 41.2% and 44.6; 13.7% and 14.0% respectively, p=0.80884. There was no significant difference in the incidence of COVID-19 and hospitalization associated with this disease in patients taking various biologics or JAK inhibitors. Conclusion Despite the COVID-19 pandemic, rituximab remains one of the most popular bDMARD. About a third of patients receiving bDMARDs and JAK inhibitors aren’t satisfied with their condition. More than 40% of patients treated with these drugs experienced COVID-19, and 14.0% required hospitalization. Disclosure of Interests None declared
POS1345 BEYOND PULMONARY ARTERY ANEURYSM; PULMONARY INVOLVEMENT IN BEHCET’S SYNDROME
Authors: R. Yildirim, M. Dinler, S. Oğuzman, N. S. Yasar Bilge, T. Kaşifoğlu
Journal: Annals of the Rheumatic Diseases (2022)

Background Pulmonary involvement (PI) other than pulmonary artery aneurysm (PAA) in Behcet’s syndrome (BS) is still an area of investigation. Objectives Herein, we aimed to retrospectively evaluate all types of pulmonary involvement associated with Behcet’s syndrome (BS). Methods Among 800 BS patients according to International Study Group for Behcet’s Disease (ISG) criterias, 28 patients were selected based on their radiologic examination consistent with BS-related PI. Demographic features, other clinical manifestations of BS, treatment modalities and types of PI were analyzed. Results The overall prevalence of PI was estimated 3,5% among all BS patients. PI was more common in males (82.1% vs 17.9%). Mean age for BS diagnosis and onset of PI were as following; 32 ± 10,9 and 37 ± 11,4 years. Deep vein thrombosis (DVT) was the most common accompanying vascular involvement (53,6%). PAA, pulmonary vasculitis (PV), and pulmonary thromboembolism (PTE) were seen in 7 (25%), 13 (46,3%), and 18 (64,4%) of patients, respectively. In 5 patients, intracardiac thrombosis was present simultaneously in the right ventricle. Cyclophosphamide (CYC) was the most common preferred agent (78%) followed by azathioprine (AZA) as first line. Warfarin used in 18 patients (Table 1) Mortality was seen in 3 patients during follow up (1 due to PAA bleeding, others with unknown causes). Table 1. Characteristics of pulmonary involvement in BS patients Male/Female, (n), (%) 23/5 (82,1%/17,9%) Age of diagnosis, years (Mean± SD) 32 ± 10,9 Age of pulmonary involvement, years (Mean ± SD) 37 ± 11,4 Oral ulcer, (n), (%) 28 (100%) Genital ulcer, (n), (%) 20 (71,4%) Osteofollicular lesion,(n), (%) 20 (71,4%) Erythema nodosum, (n), (%) 13 (46,4%) Uveitis, (n), (%) 8 (28,6%) DVT, (n), (%) 15 (53,6%) Cardiac involvement, (n), (%) 5 (17,8%) Pulmonary involvement, (n)-PAA, (n), (%) 287 (25%) -PV, (n), (%) 13 (46,4%) -PTE, (n), (%) 18 (64,3%) Immunosuppression (first line agents) 26/28 -Steroid, (n), (%) 26/28 -CYC, (n), (%) 22/26 (84,6%) -AZA, (n), (%) 4/26 (15%) Anticoagulation (warfarin), (n), (%) 18 PAA; pulmonary artery aneurysm, PTE; pulmonary thromboembolism, PV; pulmonary vasculitis, CYC; cyclophosphamide, AZA; azathioprine, DVT; deep vein thrombosis Conclusion Despite the importance of PAA in BS patients, capillaritis and thromboembolism other than PAA may occur commonly in BS as well. Onset at young age, male gender and previous DVT seem to be significant risk factors for the development of PI. References [1]Yazgan Ç, Ertürk H, Taşkin A. Imaging Features of Thoracic Manifestations of Behçet’s Disease: Beyond Pulmonary Artery Involvement. Curr Med Imaging. 2021;17(8):996-1002. Disclosure of Interests None declared
AB0257 ADHERENCE TO TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: P. Postnikova, P. Kovalenko, I. Dydykina, A. Abolyoshina, A. Smirnov, A. Lila
Journal: Annals of the Rheumatic Diseases (2022)

Background Adherence is defined as the degree of agreement between a patient’s behavior (taking medication, changing lifestyle, or adhering to treatment recommendations) and the prescriptions of a physician or medical staff. The patient’s adherence to treatment is an important factor influencing the effectiveness of therapy, the course of the disease. In Russia, a universal questionnaire was developed to assess the level of adherence to drug therapy, medical care, lifestyle changes, and general adherence to treatment. Objectives To analyze the adherence to treatment, medical care and recommendations for lifestyle changes in patients with RA. Methods The cross-sectional study included 88 women with RA (ACR/EULAR 2010), the mean age - 63.0±8.1 years, the duration of the disease - 22.4±9.3 years. Adherence was assessed using the Russian questionnaire, which determines the low, average, and high levels of adherence to drug therapy, medical care, recommendations for lifestyle changes, and general adherence to treatment. All patients completed The Hospital Anxiety and Depression Scale (HADS) for the evaluation of anxious and depressive symptoms and HAQ (Health Assessment Questionnaire) to explore functional disability. All patients took a clinical examination, assessment of the anamnestic data, X-ray of hands, feet. Results Most of RA patients had an average level of adherence to drug therapy - 51 (58%); medical care - 45 (51%); low level of adherence to lifestyle recommendations – 63 (72%). Assessment of general adherence to treatment showed: 30 (34%) people had a low level of adherence, 51 (58%) - medium, and 7 (8%) - high. Elderly age (p=0.00), anxiety (p=0.02) and depression (p=0.04) were associated with low adherence to medical care. The use of glucocorticoids (GCs) was associated with high adherence to drug therapy (p=0.01). The number of patients taking disease-modifying anti-inflammatory drugs and biologic disease-modifying antirheumatic drugs, functional disability (HAQ) and the radiographic stage of RA (classified according to Steinbrocker) did not differ significantly in patients with different levels of adherence. Conclusion Most of RA patients had an average level of adherence to drug therapy, medical care, and a low level of adherence to recommendations for lifestyle changes. Patients taking GCs have a high level of adherence to drug therapy. Mental disorders (anxiety and depression) and elderly age are associated with low adherence to medical care. Disclosure of Interests None declared
AB0143 CHARACTERIZATION OF CELLULAR INFILTRATE IN TEMPORAL ARTERITIS USING IMAGING MASS CYTOMETRY IN GIANT CELL ARTERITIS
Authors: M. Robert, H. A. Michaud, L. A. Chepeaux, A. Sannier, T. Papo, K. Sacre
Journal: Annals of the Rheumatic Diseases (2022)

Background Imaging mass cytometry (IMC) is a high-plex imaging technique that incorporates flow cytometry principles while preserving the histological and architectural components of the tissue sample. Characterizing the entire cellular component of temporal artery (TA) in patients with giant cell arteritis (GCA) may provide clues towards novel diagnostic and therapeutic approaches. Objectives We aimed at a comprehensive summary of the immune cells and pathways involved GCA by using IMC approach. Methods TA samples from biopsy-proven GCA patients (n=2) and controls (CTLs, n=2) were analyzed using IMC with a panel of 15 staining antibodies. Results Eleven cell populations were identified in arterial wall from GCA patients including both immune (CD20+ B cells, CD8+ T cells, CD4+ T cells, FOXP3+ Tregs, CD66b+ granulocytes, CD11b+ myeloid cells, CD14+ monocytes, CD68+ macrophages) and non-immune (aSMA+ smooth muscle cells, CD31+ endothelial cells, Vimentin+ fibroblasts) cells (Figure 1). The 3 layers (intima, media and adventitia) of the arterial wall was enriched by all the immune cell subsets in GCA except for granulocytes and myeloid cells. CD8+, CD4+ and FOXP3+ regulatory T cells were significantly increased in any layer of the TA. The proportion of B cells was also enhanced in both intima and adventitia and displayed a high level of Ki67 expression. Figure 1. Unbiased clustering of cellular infiltrate in temporal arteritis using Imaging Mass Cytometry. Heatmap of different cell type markers expressed by the 11 cell populations identified in the arterial wall of GCA patients: CD20+ B cells, CD8+ T cells, CD4+ T cells, FOXP3+ Tregs, CD66b+ granulocytes, CD11b+ myeloid cells, CD14+ monocytes, CD68+ macrophages, Vimentin+ fibroblasts, aSMA+ smooth muscle cells and CD31+ endothelial cells. A population of unidentified cells is also represented (A). Donut chart representing the relative composition of immune cells in the arterial wall of GCA patients (B). tSNE dimensional plots of the different cell clusters identified in the arterial wall of CTL and GCA patients (C). Percent and Heatmap of immune cells identified in the arterial wall of each patient (D). GCA: giant cell arteritis, CTL: controls, Tregs: regulatory T cells. Conclusion Our study provides an exhaustive overview of the distinct cell lineages involved in GCA and supports IMC approach to further characterize the immune networks active in GCA. Disclosure of Interests None declared
AB1474 LIPIDOMIC PROFILING IDENTIFIES SERUM LIPIDS ASSOCIATED WITH PERSISTENT MULTISITE MUSCULOSKELETAL PAIN
Authors: C. Ma, M. Liu, J. Tian, G. Zhai, F. Cicuttini, Y. Schooneveldt, P. Meikle, G. Jones, F. Pan
Journal: Annals of the Rheumatic Diseases (2022)

Background Lipid mediators have been suggested to have a role in pain sensitivity and response; however, longitudinal data on lipid metabolites and persistent multisite musculoskeletal pain (MSMP) are lacking. Objectives This study was to identify lipid metabolic markers for persistent MSMP. Methods Lipidomic profiling of 807 lipid species was performed on serum samples of 536 participants from a cohort study. MSMP was measured by a questionnaire and defined as painful sites ≥4. Persistent MSMP was defined as having MSMP at every visit. Logistic regression was used with adjustment for potential confounders. The Benjamini Hochberg method was used to control for multiple testing. Results A total of 530 samples with 807 lipid metabolites passed quality control. Mean age at baseline was 61.54±6.57 years and 50% were females. One hundred and twelve (21%) of the participants had persistent MSMP. Persistent MSMP was significantly associated with lower levels of monohexosylceramide (HexCer)(d18:1/22:0 and d18:1/24:0), acylcarnitine (AC)(26:0) and lysophosphatidylcholine (LPC)(18:1 [sn1], 18:2 [sn1], 18:2 [sn2], and 15-MHDA[sn1] [104_sn1]) after controlling for multiple testing. After adjustment for age, sex, body mass index, diabetes status, and physical activity, HexCer(d18:1/22:0 and d18:1/24:0) and LPC(18:1 [sn1] and 15-MHDA [sn1] [104_sn1]) were significantly associated with persistent MSMP [Odds Ratio (OR) ranging from 0.24 - 0.32]. Two lipid classes -- HexCer and LPC were negatively associated with persistent MSMP after adjustment for covariates (OR=0.19 and 0.21, respectively). Conclusion This study identified four novel lipid signatures of persistent MSMP, suggesting that lipid metabolism is involved in the pathogenesis of persistent pain. Disclosure of Interests None declared
POS0913 INCREASED HEALTH CARE UTILIZATION IN SYSTEMIC SCLEROSIS PATIENTS WHO HAVE DIGITAL ULCERS
Authors: T. Nevskaya, L. Martin Calderon, M. Baron, J. Pope
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic sclerosis is a multi-system autoimmune disease characterized by fibrosis of the skin and internal organs, and vasculopathy which manifests as pulmonary arterial hypertension and digital ulcers. Digital ulcers are debilitating and painful lesions most commonly present in the digit tips or extensor surfaces of the hands leading to significant morbidity and decreased quality of life. SSc patients with digital ulcers may require increased support and therefore may have greater healthcare resource utilization compared to those patients without digital ulcers. Objectives We assessed the impact of DUs on resource utilization including hospitalizations, outpatient visits and procedures within a large SSc Canadian registry. Methods A cohort of patients with SSc and digitals ulcers was derived from the Canadian Scleroderma Research Group registry and matched to controls individually based on sex, age (±3 years), SSc subtype, and disease duration (±2 years). Eligible patients met the 2013 ACR/EULAR criteria (confirmed by an experienced rheumatologist), were 18 years of age, had completed the Resource Utilization Questionnaire (RUQ), and had active digital ulcers at two consecutive annual visits (baseline study visit and at 1 st year). The Medgser Disease Severity Scale was used to assess ulcer disease severity. Unadjusted and adjusted regression analyses compared the association between DUs and resource utilization. Results RUQs in 104 SSc patients with active DUs at two consecutive annual visits were compared with 104 patients without DUs matched 1:1 for age, sex, disease subtype and duration. Over one year, DUs were associated with a higher number of tests (p˂0.05) and visits to health professionals, especially to a rheumatologist (p˂0.0001) and internist (p=0.003), a greater need for an accompanying person (p˂0.05) and aids purchased/received (p˂0.05). Having DUs was associated with more severe disease, even after excluding the peripheral vascular domain from a total DSS (9.7±4.5 vs 5.6±2.7, p˂0.0001). After adjustment for disease severity in other organs, the presence of DUs remained a significant predictor of more frequent physician visits and more tests (all˂0.05) by linear regression analysis. Conclusion SSc patients with DUs utilized significantly more healthcare resources per annum even after adjustment for disease severity in other organ systems. References [1]Khimdas S, Harding S, Bonner A, Zummer B, Baron M, Pope J, Canadian Scleroderma Research Group. Associations with digital ulcers in a large cohort of systemic sclerosis: results from the Canadian Scleroderma Research Group registry. Arthritis care &amp; research. 2011 Jan;63(1):142-9. [2]Nihtyanova SI, Brough GM, Black CM, Denton CP. Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis. Annals of the rheumatic diseases. 2008 Jan 1;67(1):120-3. Disclosure of Interests None declared